HAM CHATTER INTERVIEW FORM

Name________________________________________ Call_________________

QTH_________________________________________

Original QTH______________________________

Other QTH’s______________________________

 

 

When interested in AR and when licensed, past callsigns_________________________

 

  

Equipment________________________________________________________

 

  

Operating preferences________________________________________________

 

  

Club activities______________________________________________________

 

  

Past activities, awards, etc. in AR________________________________________

 

 

Education__________________________________________________________

 

  

Past & present

Occupation_________________________________________________________

 

 

Family____________________________________________________________

 

Enter any other information that may be of interest to club members concerning your amateur radio experience or other activities for the Meet the Members column.

Print this form out and use additional sheets if needed. Return to W4YDY barc @ w4amc.com (remove spaces)


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Copyright - 2011 - David W. Langley, W4YDY